United States Department of TransportationStrategies to Reduce Crashes and Injuries Involving Older Drivers
The overall goal of older-driver-related countermeasures is to enable older drivers to retain as much mobility through driving as is consistent with safety on the road for themselves, their passengers, and other road users. “Safe mobility for life” was the key phrase used in the U.S. Department of Transportation’s Safe Mobility for a Maturing Society: Challenges and Opportunities plan published in 2003 (U.S. DOT, 2003). The plan established strategies to address safe mobility on the State or local level. Strategies included educating and training older drivers to assess their driving capabilities and limitations; improving skills when possible; voluntarily limiting driving to circumstances in which they feel most comfortable driving; helping drivers adapt to medical or functional limitations affecting driving with treatment (such as eyeglasses or cataract surgery to improve vision) or vehicle adaptations (such as extra mirrors, extended gear shift levers, hand controls, or pedal extenders); and using license renewal procedures or referrals from law enforcement, clinicians (primary care providers or specialists), family, or friends to identify older drivers who cannot drive safely, in certain situations or at all, and restrict or revoke their driver’s licenses.
In 2005 NHTSA developed the Older Driver Traffic Safety Plan that synthesized research findings and expert opinions and guided subsequent NHTSA research and programs (NHTSA, 2005). Building on that work, NHTSA produced the Older Driver Program Five-Year Strategic Plan in 2010 focused on how NHTSA would address the safety needs of older drivers from 2012 to 2017 (NHTSA, 2010). Based on interviews and expert panel input and other research, NHTSA identified three main program initiatives (communications, partnerships, and driver licensing policies) to guide the implementation of its Older Driver Traffic Safety Plan for 2012-2017.
In 2013 NHTSA developed the Traffic Safety for Older People – 5-Year Plan to address traffic safety concerns of older road users - drivers, passengers, and pedestrians. The plan described research and other program activities in the near term (within the next 2 years), short term (3 to 5 years), and long term (beyond 5 years from the initiation of the plan). The plan was developed around four main elements, data, vehicle, behavior, and pedestrian safety. NHTSA notes this plan was intended to be a dynamic guide, reviewed and modified in response to new research and other information related to traffic safety for older people (NHTSA, 2013). In November 2016 NHTSA conducted a day-long meeting of experts titled Enhancing Safety for Aging Road Users to identify interventions to improve older driver traffic safety. The inputs from the meeting influenced NHTSA research and program related projects for 2017-2018 and will be considered in the next revision of the Traffic Safety for Older People – 5 Year Plan. The meeting videos are available at www.nhtsa.gov/events/enhancing-safety-aging-road-users. NHTSA also provides actionable information for family and friends of older drivers on its website, including the How to Understand and Influence Older Drivers resource at www.nhtsa.gov/older-drivers/how-understand-and-influence-older-drivers.
There are vehicular, environmental, and societal strategies critical to providing safety and mobility for older people, but are for the most part beyond the control of SHSOs. Vehicles can be designed with better crash protection for older and more easily injured occupants, with controls and displays that are easier to see, reach and understand, and with crash warning and crash avoidance technology. These measures will make vehicles safer for everyone, not just older people. Aftermarket vehicle devices, such as one-hand joystick driving controls, can make driving possible or easier for people with some physical limitations. Roadways with separate left turn lanes, protected left turn signal phases, larger and more-visible signage, more- visible lane markings, rumble strips, and a host of other measures assist all drivers. These subjects are not discussed in this guide because they do not fall under direct SHSO jurisdiction. However, it is important that SHSOs become at least somewhat familiar with basic concepts of transportation planning and engineering – such as those mentioned above – since SHSOs can be expected to play increasingly important roles in partnerships to enhance older driver safety and mobility efforts.
NHTSA’s Highway Safety Program Guideline No. 13 – Older Driver Safety provides States with key elements of a comprehensive older driver safety program aiming to reduce older driver crashes, fatalities, and injuries. Many guideline elements can be addressed directly by SHSOs, as NHTSA notes, “each State older driver safety program should address driver licensing and medical review of at-risk drivers, medical and law enforcement education, roadway design, and collaboration with social services and transportation services providers” to maximize benefits. The guideline also includes recommendations for program management, communications, and program evaluation and data components that should be included in a State older driver safety program (NHTSA, 2014). FHWA also provides an updated list of resources on transportation engineering aspects as relevant to older driver and road user safety: https://safety.fhwa.dot.gov/older_users/.
Of all the subject areas in this countermeasure guide, those related to older drivers are perhaps the most complex because they involve so many issues beyond traffic safety. Sooner or later, in the interest of safety, most older people must restrict or cease driving, either by choice or as the result of the State licensing authority restricting or revoking their license. Driving cessation can have a substantial effect on the older driver’s mobility and on physical and mental health. SHSOs and licensing agencies cannot act alone but must plan and implement their older driver policies and programs as part of integrated community activities to improve older people’s safety, mobility, and health. As just one example, some communities have established referral centers where people can go for “one-stop” access to resources for addressing the full range of transportation safety and mobility issues, including driving skills assessment, educational courses, licensing regulations and practices, and public transportation. The Florida DOT, in collaboration with a range of State, industry, academic, and community partners, supports the Safe Mobility for Life Coalition (http://safemobilityfl.com/index.htm). Its coalition partners provide education, services, and tips for older drivers in community events. California’s Department of Aging collaborates with Area Agencies on Aging to provide local community-based services, including transportation assistance (www.aging.ca.gov/Programs_and_Services/Home_and_Community_Services/). See Stutts (2005) for summaries of comprehensive programs for older drivers in six States.
Several studies and policy papers discuss older driver safety. See, in particular, the Department of Transportation’s Safe Mobility for a Maturing Society: Challenges and Opportunities (U.S. DOT, 2003) and NCHRP’s Guide for Addressing Collisions Involving Older Drivers (Potts et al., 2004) for summaries and references to further information. The Organisation for Economic Co-Operation and Development’s Ageing and Transport: Mobility Needs and Safety Issues (OECD, 2001) presents a discussion from an international perspective. The NCHRP synthesis Improving the Safety of Older Road Users (Stutts, 2005) summarizes State activities as of 2005. A report issued by the AAA Foundation for Traffic Safety (Stutts & Wilkins, 2009) documents U.S. policies and practices for improving the safety of older drivers and identifies model programs. These policies and practices and model programs are updated and made available through the AAAFTS “Driver Licensing Policies and Practices” and “Noteworthy Initiatives” databases that can be searched by State or by policy/topic area (http://lpp.seniordrivers.org/).